Based on the graphical depiction, the addition of a spline knot at the 3-year mark demonstrated a slight trend towards increasing correctness of care up until the 3-year mark (OR 1.022, 95% CI 1.005 to 1.038, p=0.009), followed by decreasing correctness of care after that point (OR 0.978, 95% CI 0.970 to 0.986, p<0.001), with an improvement in model fit based on the QIC values ( table 4 ).
This study demonstrated improvement in some quality measures and worsening of other measures over time but did not assess for an overall trend in quality of care over time. 16 We previously examined trends in quality of care over the first 2 years of the iCCM programme in Bugoye using a record review approach, showing improvement in the proportions of patients receiving correct care (quality of care) over the initial 6 months after iCCM c